World report on child injury prevention n n Morbidity Fatal childpoisoningratesper100000population n n n n Mortality Scale oftheproblem the nature and dose of the poison. Poisoning departments. patternschange according toagegroup, type ofexposure and emergency to admitted are children ofthousands and happens this whencentres controlpoison to made are calls of millions are year every substances – ingested poisonous inadvertently when place surroundings dangerous its a and be home can the result, a As taste. including Children are curious and explore their world with all their senses,

fatal accidentalpoisoningsworldwide. in children and youth under 20 years of age – 13% of all In 2004, acute poisoning caused more than 45 000 deaths hospital admissioncriteria. and services to access differing of because comparable not are data regional and available not are data global but problem significant a is morbidity Poisoning countries are fourtimesthatofhigh-incomecountries. Fatal poisoning rates in low-income and middle-income one year, withanotherslightpeakaround 15years. under children for highest is poisoning fatal of rate The afterroad trafficinjuries, fires andinjury drowning. countries, unintentional of cause biggest fourth the middle-income is poisoning and high-income 16 In to bemore commonamongchildren aged1to4. children under one year, while non-fatal poisonings appear in highest are rates death poisoning countries some In Africa fact sheetLMIC 4.0 poisoning Children and HIC 0.8 Americas LMIC 0.3 East Asia South- LMIC 1.7 HIC 0.2 Europe a byWHOregionandcountryincomelevel,2004 LMIC 2.0 HIC 0.7 Mediterranean Eastern n n n n LMIC 1.6

poisoning aloneare atleastUS$1.4millionper year. that the direct costs of hospitalization because of paraffin For example, a study conducted in South Africa estimated suggest that poisonings and their management are costly. Studies from both low-income and high-income countries pharmaceuticals andcleaningagents. income countries are fuels such as paraffin and kerosene, middle- and low-income in agents poisoning Common from insectsandanimals. bites and plants poisonous pesticides, agents), cleaning include pharmaceuticals, countries household high-income products in (e.g. agents bleach, poisoning Common rates. Europe and the Western Pacific Regions have the highest Africa and low-income and middle-income countries in HIC 0.1 Western Pacific LMIC 1.8 What ispoisoning? pre-existing healthconditions. pre-existing state ofnutritionthechildor(fastingstatus);ageand tootherpoisons; of exposurethepoison;co-exposure of poisoningarethenature,dose,formulationandroute substance. Key factors that predict the severity and outcome inhalation, ingestion,injectionorabsorptionofatoxic Poisoning iswhencellsareinjuredordestroyedbythe a Source: WHO(2008),GlobalBurdenofDisease:2004update. countries. LMIC =Low-incomeandmiddle-income HIC =High-incomecountries;

These datarefertothoseunder20yearsofage. Risk factors Interventions

n Young children are particularly susceptible to the Poisoning can be reduced through the use of effective ingestion of poisons, especially liquids, because they are prevention strategies. very inquisitive, put most items in their mouths and are unaware of consequences. n Adolescents, on the other hand, are more aware of the Proven effective approaches to consequences of their actions but peer pressure and risk- taking behaviour can lead them to misuse alcohol or illicit reducing poisoning — drugs, leading to a fatality rate higher than in younger 3 Removing the poisoning agent from 3 Reducing toxicity of poisoning children. the environment (e.g. removal of agents by packaging in non-lethal n Younger children are more susceptible to poisoning poisonous plants; removal of fuel concentrations or doses. sources such as bottled kerosene). because of their smaller size and less well-developed 3 Establishing a poison control centre physiology, particularly as the toxicity of most substances 3 Replacing the poisoning agent to triage poisonings, dispensing relates to dose per kilogram of bodyweight. with one of lower toxicity (e.g. accurate and timely advice to replacing aspirin with paracetamol; caregivers and health facilities, reformulating methylated spirits to directing first aid where appropriate, include ethyl alcohol rather than and referring more severe Most common agents involved in childhood poisoning: methanol). poisonings to treatment at a health • Over-the-counter preparations • Household products such as facility. 3 Legislation (and enforcement) such as paracetamol, cough/ bleach, disinfectants, detergents, of child-resistant packaging of cold remedies, vitamins and iron cleaning agents, cosmetics, necessary poisonous agents (e.g. tablets, antihistamines and anti- vinegar. medicines, household chemicals and inflammatory drugs. • Paraffin/kerosene. other toxins). • Prescription medications such • Pesticides, including insecticides, as antidepressants, narcotics, rodenticides and herbicides. analgesics and illicit drugs. • Poisonous plants. • Animal or insect bites. What does not work? 7 n There is insufficient evidence to promote the regulation or removal of toxic Boys have higher rates of poisoning than girls in all substances that are easily mistaken for edible items, or reducing the attractiveness regions of the world, probably because of differences in or labelling of toxic products. socialization. 7 The introduction of non-standardized, non-reclosable or blister packaging for n Fatal and non-fatal poisonings are strongly associated tablets has the potential to be harmful as these may not be child-resistant. with lower socioeconomic status, between and within countries. n The prevalence and types of poisoning vary in different parts of the world. They depend on industrial development, agricultural activities, cultural practices relating to supervision of children and local beliefs and customs. For example, medicinal drugs are the leading cause of non-fatal poisoning in children in middle- income to high-income countries, and ingestion of fuels such as kerosene is a common cause in low-income countries. n Other risk factors for poisoning include those related to the poisoning agent itself, including toxicity, nature, physical appearance and storage; season and weather conditions; policies, standards and laws governing the manufacture, labelling, distribution, storage and disposal of poisoning agents; and access to quality health care for treatment.

“All things are poison and nothing is without poison, only the dose permits something not to be poisonous.

fact sheet fact ” Paracelsus Encyclopaedia Britannica

Source: This fact sheet is based on the World report on child injury prevention. To download a copy of the report please go to http://www.who.int/violence_injury_prevention/child/en/ Copies of this document are available from: Department of Violence and Injury Prevention and Disability, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland, Email: [email protected]